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Final |/Exam |/NU664 |/Set |/ 2 |/QUESTIONS |/WITH
|/ANSWERS
Somatic |/Symptom |/Disorder |/(Hypochondriasis) |/Diagnostic |/criteria |/- |/CORRECT |/ANSWERS |/✔✔A. |/ 1 |/or |/more |/somatic |/symptoms |/that |/are |/distressing |/or |/cause |/significant |/disruption |/of |/daily |/life B. |/Excessive |/thoughts, |/feelings, |/or |/behaviors |/r/t |/somatic |/symptoms |/or |/health |/concerns |/manifested |/by |/at |/least |/ 1 |/of |/the |/following:
- |/Disproportionate |/& |/persistent |/thoughts |/about |/the |/seriousness |/of |/one's |/symptoms
- |/Persistently |/high |/anxiety |/about |/health |/or |/symptoms
- |/Excessive |/time |/or |/energy |/devoted |/to |/symptoms |/or |/health |/concerns C. |/State |/of |/being |/symptomatic |/is |/persistent |/(more |/than |/ 6 |/months) Somatic |/Symptom |/Disorder |/(Hypochondriasis) |/Common |/differentials |/and |/assessment |/strategies |/- |/CORRECT |/ANSWERS |/✔✔Nonpsych |/medical |/conditions |/that |/show |/symptoms |/that |/are |/not |/easily |/diagnosed |/such |/as |/AIDS, |/endocrinopathies, |/myasthenia |/gravis, |/multiple |/sclerosis, |/degenerative |/diseases |/of |/the |/nervous |/system, |/systemic |/lupus |/erythematosus, |/and |/occult |/neoplastic |/disorders
Somatic |/Symptom |/Disorder |/(Hypochondriasis) |/Epidemiology |/- |/CORRECT |/ANSWERS |/✔✔A. |/Men |/& |/women |/equally |/affected B. |/More |/common |/in |/black |/people |/than |/white |/people Somatic |/Symptom |/Disorder |/(Hypochondriasis) |/Onset, |/progression |/- |/CORRECT |/ANSWERS |/✔✔A. |/Can |/occur |/at |/any |/age, |/but |/most |/commonly |/appears |/in |/people |/between |/age |/ 20 |/to |/ 30 B. |/Usually |/episodic |/- |/episodes |/last |/from |/months |/to |/years |/separated |/by |/equally |/long |/periods |/of |/dormancy Somatic |/Symptom |/Disorder |/(Hypochondriasis) |/General |/presentations |/and |/features |/of |/this |/diagnostic |/group |/- |/CORRECT |/ANSWERS |/✔✔A. |/Believe |/they |/have |/a |/serious |/disease |/that |/has |/not |/yet |/been |/detected |/and |/cannot |/be |/persuaded |/otherwise B. |/Can |/present |/as |/pain, |/fatigue, |/nausea, |/dizziness, |/fainting, |/etc. C. |/Depressive |/and |/anxiety |/symptoms |/commonly |/accompany |/somatic |/symptoms Somatic |/Symptom |/Disorder |/(Hypochondriasis) |/Treatment |/- |/CORRECT |/ANSWERS |/✔✔A. |/Most |/will |/not |/agree |/to |/treatment |/because |/they |/do |/not |/believe |/they |/have |/a |/psychiatric |/problem B. |/Psychotherapy C. |/Pharmacotherapy |/only |/works |/if |/they |/have |/an |/underlying |/condition |/such |/as |/anxiety |/or |/depressive |/disorder
Illness |/Anxiety |/Disorder |/Onset, |/progression |/- |/CORRECT |/ANSWERS |/✔✔A. |/Can |/occur |/at |/any |/age |/- |/no |/specific |/age |/of |/onset B. |/Typically |/chronic Illness |/Anxiety |/Disorder |/General |/presentations |/and |/features |/of |/this |/diagnostic |/group |/- |/CORRECT |/ANSWERS |/✔✔A. |/Few |/to |/no |/somatic |/symptoms |/but |/person |/is |/primarily |/concerned |/that |/they |/are |/ill B. |/Can |/have |/a |/medical |/illness, |/but |/anxiety |/is |/out |/of |/proportion |/for |/the |/medical |/diagnosis |/and |/they |/assume |/the |/worst |/possible |/outcome C. |/Often |/there |/is |/an |/obsessive |/quality |/to |/person's |/fear Illness |/Anxiety |/Disorder |/Treatment |/- |/CORRECT |/ANSWERS |/✔✔A. |/Most |/will |/not |/agree |/to |/treatment |/because |/they |/do |/not |/believe |/they |/have |/a |/psychiatric |/problem B. |/Psychotherapy C. |/Pharmacotherapy |/to |/treat |/anxiety Conversion |/Disorder |/Diagnostic |/criteria |/- |/CORRECT |/ANSWERS |/✔✔A. |/ 1 |/or |/more |/symptoms |/of |/altered |/voluntary |/motor |/or |/sensory |/function B. |/Clinical |/findings |/provide |/evidence |/of |/incompatibility |/between |/the |/symptom |/and |/recognized |/neurological |/or |/medical |/conditions
C. |/Symptom |/or |/deficit |/not |/better |/explained |/by |/another |/medical |/or |/mental |/disorder D. |/Symptom |/or |/deficit |/cause |/significant |/distress |/or |/impairment |/in |/social, |/occupational, |/or |/other |/areas |/of |/functioning |/or |/warrants |/medical |/evaluation Conversion |/Disorder |/Common |/differentials |/and |/assessment |/strategies |/- |/CORRECT |/ANSWERS |/✔✔Any |/and |/all |/diagnoses |/that |/can |/cause |/the |/symptoms |/the |/patient |/is |/experiencing |/must |/be |/considered Conversion |/Disorder |/Epidemiology |/- |/CORRECT |/ANSWERS |/✔✔A. |/Is |/the |/most |/common |/somatoform |/disorder B. |/More |/common |/in |/females C. |/More |/common |/on |/left |/side |/than |/right |/side |/of |/the |/body |/in |/women D. |/More |/common |/in |/rural |/populations, |/people |/with |/little |/education, |/low |/IQs, |/low |/socioeconomic |/groups, |/& |/military |/personnel |/who |/have |/been |/exposed |/to |/combat Conversion |/Disorder |/Onset |/- |/CORRECT |/ANSWERS |/✔✔A. |/Onset |/between |/late |/childhood |/to |/early |/adulthood B. |/Rare |/before |/age |/ 10 |/or |/after |/age |/ 35
- |/Psychogenic |/vomiting
- |/Pseudocyesis |/(false |/belief |/of |/being |/pregnant |/that |/is |/associated |/with |/objective |/signs |/and |/reported |/symptoms |/of |/pregnancy)
- |/Globus |/hystericus |/(feeling |/of |/something |/stuck |/in |/throat)
- |/Swooning |/or |/syncope
- |/Urinary |/retention
- |/Diarrhea Conversion |/Disorder |/Treatment |/- |/CORRECT |/ANSWERS |/✔✔A. |/Psychotherapy B. |/Anxiolytics C. |/Longer |/the |/duration |/of |/disorder, |/the |/more |/difficult |/to |/treat Psychological |/Factors |/Affecting |/Other |/Medical |/Conditions |/Diagnostic |/criteria |/- |/CORRECT |/ANSWERS |/✔✔A. |/Medical |/symptom |/or |/condition |/(other |/than |/mental |/disorder) |/is |/present B. |/Psychological |/or |/behavioral |/factors |/affect |/the |/medical |/condition |/in |/one |/of |/the |/following |/ways:
- |/Factors |/have |/influenced |/the |/course |/of |/the |/medical |/condition |/(ie. |/development, |/exacerbation, |/or |/delayed |/recovery |/of |/medical |/condition)
- |/Factors |/interfere |/with |/treatment |/of |/medical |/condition |/(ie. |/poor |/adherence)
- |/Factors |/constitute |/additional |/well-established |/health |/risks |/for |/the |/person
- |/Factors |/influence |/underlying |/pathophysiology, |/precipitating |/or |/exacerbating |/symptoms |/or |/necessitating |/medical |/attention C. |/Psychological |/or |/behavioral |/factors |/in |/criterion |/B |/are |/not |/better |/explained |/by |/another |/mental |/disorder |/(ie. |/panic |/disorder, |/MDD, |/PTSD) Factitious |/Disorder |/(Munchausen |/Syndrome) |/(Can |/be |/imposed |/on |/self |/or |/on |/another) |/Diagnostic |/criteria |/- |/CORRECT |/ANSWERS |/✔✔A. |/Falsification |/of |/physical |/or |/psychological |/signs |/or |/symptoms, |/or |/induction |/of |/injury |/or |/disease, |/associated |/with |/deception B. |/Presents |/themselves |/(or |/another) |/to |/others |/as |/ill, |/impaired, |/or |/injured C. |/Deceptive |/behavior |/is |/evident |/even |/when |/there |/are |/no |/external |/rewards D. |/Behavior |/is |/not |/better |/explained |/by |/another |/mental |/disorder |/(ie. |/delusional |/disorder |/or |/another |/psychotic |/disorder) Common |/differentials |/and |/assessment |/strategies |/of |/Factitious |/Disorder |/(Munchausen |/Syndrome) |/(Can |/be |/imposed |/on |/self |/or |/on |/another) |/- |/CORRECT |/ANSWERS |/✔✔Any |/and |/all |/diagnoses |/that |/can |/cause |/the |/symptoms |/the |/patient |/is |/experiencing |/must |/be |/considered
E. |/Reluctance |/to |/give |/access |/to |/collateral |/sources |/of |/information |/(ie. |/refusing |/to |/sign |/release |/of |/info |/or |/to |/give |/contact |/info |/for |/family |/or |/friends) F. |/Extensive |/medical |/hx |/or |/multiple |/surgeries G. |/Multiple |/drug |/allergies H. |/Medical |/profession I. |/Few |/visitors J. |/Ability |/to |/forecast |/unusual |/progression |/of |/symptoms |/or |/response |/to |/treatment Treatment |/of |/Factitious |/Disorder |/(Munchausen |/Syndrome) |/(Can |/be |/imposed |/on |/self |/or |/on |/another) |/- |/CORRECT |/ANSWERS |/✔✔A. |/No |/specific |/psychiatric |/treatment |/has |/been |/effective |/in |/treating |/factitious |/disorders B. |/Better |/to |/focus |/on |/management |/than |/cure C. |/Pharmacotherapy |/is |/limited |/in |/use |/- |/could |/use |/SSRIs |/to |/decrease |/impulsive |/behavior |/when |/that's |/a |/major |/component Other |/Specified |/Somatic |/Symptom |/& |/Related |/Disorder |/- |/CORRECT |/ANSWERS |/✔✔o |/Brief |/somatic |/symptom |/disorder: |/symptoms |/less |/than |/ 6 |/months o |/Brief |/illness |/anxiety |/disorder: |/symptoms |/less |/than |/ 6 |/months o |/Illness |/anxiety |/disorder |/without |/excessive |/health-related |/behaviors: |/Criterion |/D |/of |/Illness |/Anxiety |/Disorder |/is |/not |/met
o |/Pseudocyesis: |/False |/belief |/of |/being |/pregnant |/that |/is |/associated |/with |/objective |/signs |/and |/reported |/symptoms |/of |/pregnancy Unspecified |/Somatic |/Symptom |/& |/Related |/Disorder |/- |/CORRECT |/ANSWERS |/✔✔o |/Used |/for |/symptoms |/that |/are |/characteristic |/of |/somatic |/symptom |/& |/related |/disorder |/but |/do |/not |/meet |/the |/full |/criteria |/of |/any |/of |/the |/disorders |/in |/that |/diagnostic |/class Insomnia |/diagnostic |/criteria |/- |/CORRECT |/ANSWERS |/✔✔A. |/A |/predominant |/complaint |/of |/dissatisfaction |/with |/sleep |/quality |/or |/quantity, |/associated |/with |/ 1 |/or |/more |/of |/the |/following:
- |/Difficulty |/initiating |/sleep
- |/Difficulty |/maintaining |/sleep
- |/Early-morning |/awakening |/with |/inability |/to |/return |/to |/sleep B. |/Causes |/significant |/distress/impairment |/in |/important |/areas |/of |/functioning C. |/Occurs |/at |/least |/ 3 |/nights |/per |/week D. |/Present |/for |/at |/least |/ 3 |/months E. |/Opportunity |/for |/sleep |/is |/available F. |/Not |/better |/explained |/by |/other |/diagnosis G. |/Not |/due |/to |/medications/substances
b. |/In |/children |/or |/in |/individuals |/within |/ 6 |/months |/of |/onset, |/spontaneous |/grimaces |/or |/jaw-opening |/episodes |/with |/tongue |/thrusting |/or |/a |/global |/hypotonia, |/without |/any |/obvious |/emotional |/triggers. Hypocretin |/deficiency |/- |/CORRECT |/ANSWERS |/✔✔Cerebral |/spinal |/fluid) DSM-5 |/utilizes |/the |/same |/criteria |/for |/major |/depression |/in |/youth/adults; |/except |/- |/CORRECT |/ANSWERS |/✔✔to |/meet |/criteria |/children/adolescents |/may |/experience |/irritability |/instead |/of |/depressed |/mood; |/even |/hallucinations/delusions. Very |/young |/children |/with |/depression |/- |/CORRECT |/ANSWERS |/✔✔are |/often |/observed |/sad, |/listless, |/and |/apathetic. |/They |/may |/experience |/frequent |/somatic |/symptoms |/such |/as |/stomachaches |/and |/headaches; |/with |/poor |/self-esteem. Late |/adolescent |/age |/with |/depression |/- |/CORRECT |/ANSWERS |/✔✔may |/experience |/moodiness, |/anhedonia, |/hopelessness, |/worthlessness, |/sleep |/changes, |/severe |/psychomotor |/retardation, |/tearfulness, |/and |/delusions. Any |/Age |/with |/depression |/- |/CORRECT |/ANSWERS |/✔✔depressed/irritable |/mood, |/isolation, |/concentration |/issues, |/changes |/in |/appetite, |/changes |/in |/energy, |/SI.
Considerations |/in |/Pediatric |/Depression: |/- |/CORRECT |/ANSWERS |/✔✔family |/hx, |/stressors/abuse/neglect/trauma, |/remission |/may |/be |/noted |/if |/a |/toxic |/family |/dynamic |/improves; |/ADHD, |/ODD |/and |/conduct |/disorder |/are |/not |/frequently |/comorbid |/with |/a |/major |/depressive |/disorder. |/Rule |/out |/anemia, |/thyroid |/issues, |/vitamin |/D |/deficiency Screening |/tools |/for |/pediatric |/depression |/- |/CORRECT |/ANSWERS |/✔✔Children's |/Depression |/Rating |/Scale |/(CDRS-R); |/17-point |/scale, |/PHQ- Treatment |/of |/pediatric |/depression |/- |/CORRECT |/ANSWERS |/✔✔Psychotherapy |/in |/mild |/cases, |/moderate |/to |/severe |/cases |/require |/psychopharmacology |/and |/CBT/ |/or |/IPT. |/For |/those |/with |/Prozac |/(age |/ 8 |/and |/older) |/and |/Lexapro |/(age |/ 12 |/and |/older) |/are |/FDA |/approved |/in |/this |/population. |/Monitoring |/closely |/especially |/for |/the |/few |/months |/of |/treatment |/as |/per |/the |/Black |/box |/warning |/suicidality |/for |/those |/less |/than |/ 24 |/years |/of |/age. |/START |/LOW |/AND |/IF |/INDICATED |/INCREASE |/SLOWLY. Criteria |/for |/diagnosis |/of |/anxiety |/in |/pediatrics |/- |/CORRECT |/ANSWERS |/✔✔Excessive |/worry |/or |/fear |/that |/last |/over |/six |/months; |/impacting |/normal |/function. |/difficulty |/with |/transitions, |/increased |/mood |/swings |/during |/stressful |/periods, |/psychosomatic |/symptoms
Generalized |/anxiety |/disorder |/- |/CORRECT |/ANSWERS |/✔✔excessive |/worrying. |/Duloxetine |/approved |/GAD |/for |/this |/population School |/Refusal |/- |/CORRECT |/ANSWERS |/✔✔may |/occur |/as |/a |/result |/of |/social |/anxiety, |/separation |/anxiety; |/requires |/prompt |/attention. |/Multidisciplinary |/action |/is |/needed. OCD |/in |/peds |/- |/CORRECT |/ANSWERS |/✔✔may |/present |/with |/cooccurring |/conditions |/such |/as |/onychophagia |/trichotillomania, |/cheek |/biting, |/and |/dermatillomania. |/Approved |/meds |/are |/Prozac, |/Zoloft, |/Fluvoxamine. |/PANDAS |/should |/be |/considered |/in |/all |/children |/with |/sudden |/onset |/of |/OCD |/symptoms. |/More |/common |/in |/boys |/than |/girls. Screening |/tools |/in |/pediatric |/anxiety |/- |/CORRECT |/ANSWERS |/✔✔Pediatric |/anxiety |/scale. |/Self-Report |/for |/Childhood |/Anxiety |/Related |/Disorders |/(SCARED), |/Hamilton |/Scale Considerations |/in |/Pediatric |/Anxiety |/- |/CORRECT |/ANSWERS |/✔✔caffeine |/intake, |/asthma/other |/pulmonary |/disorders, |/cardiac |/disorders, |/endocrine |/disorders/hyperthyroidism/ |/hypoglycemia, |/adverse |/medication |/effects, |/illicit |/drug |/use, |/stimulant |/use, |/and |/diet |/pills. Treatment |/in |/Pediatric |/Anxiety |/- |/CORRECT |/ANSWERS |/✔✔the |/first |/line |/medications |/for |/pediatric |/GAD |/are |/selective |/serotonin |/reuptake |/inhibitors |/(SSRIs). |/If |/SSRIs |/with |/or |/without |/psychotherapy |/do |/not |/provide |/any |/effect, |/the |/pediatric |/patient |/may |/be |/able |/to |/benefit
|/from |/alternative |/short-term |/treatments |/such |/as |/diphenhydramine, |/hydroxyzine, |/or |/Buspar. |/Because |/Buspar |/is |/not |/a |/fast-acting |/medication; |/one |/should |/expect |/to |/notice |/results |/(from |/the |/Buspar) |/in |/upwards |/of |/one |/to |/four |/weeks. |/In |/children |/alpha |/agonists |/such |/as |/Clonidine |/and |/guanfacine |/are |/often |/used. |/START |/LOW |/AND |/IF |/INDICATED |/INCREASE |/SLOWLY. One |/should |/note |/unstable |/and |/fluctuating |/moods |/are |/- |/CORRECT |/ANSWERS |/✔✔common |/in |/pediatrics, |/especially |/in |/those |/younger |/than |/ten Pediatric |/Bipolar |/I |/Disorder |/- |/CORRECT |/ANSWERS |/✔✔ 7 |/days |/(more |/days |/than |/not |/in |/an |/average |/week) Severe— |/parents |/often |/are |/afraid |/to |/take |/the |/child |/out |/in |/public |/because |/of |/mood |/symptoms Daily |/cycles |/of |/euphoria |/and |/depression Euphoria: |/ 30 |/to |/ 60 |/minutes |/Depression: |/ 30 |/minutes |/to |/ 6 |/hours Pediatric |/Bipolar |/disorder |/NOS |/- |/CORRECT |/ANSWERS |/✔✔Frequency |/of |/symptoms |/ 2 |/to |/ 3 |/days/ |/week Moderate |/Intensity |/of |/Symptoms 3 |/to |/ 4 |/number |/of |/mood |/cycles/day 4 |/hours |/duration |/of |/symptoms
In |/children |/with |/pediatric |/bipolar |/disorder |/- |/CORRECT |/ANSWERS |/✔✔clustering |/together |/of |/episodes |/or |/'mini-episodes' |/(several |/days) |/of |/increased |/energy, |/decreased |/need |/for |/sleep, |/increased |/mood |/cycling; |/pressured |/speech, |/anger, |/irritability, |/severe |/violent |/outbursts, |/attacking |/behavior |/etc. In |/adolescents |/with |/bipolar |/disorder |/- |/CORRECT |/ANSWERS |/✔✔depressive |/episodes |/with |/episodes |/of |/hypomania |/or |/mania Patients |/with |/BD |/typically |/exhibit |/what |/is |/best |/described |/as |/- |/CORRECT |/ANSWERS |/✔✔a |/"mood |/cycle"—a |/pronounced |/shift |/in |/mood |/and |/energy |/from |/ 1 |/extreme |/to |/another. In |/pediatric |/bipolar |/disorder |/- |/CORRECT |/ANSWERS |/✔✔Assess |/family |/history, |/medical |/history, |/head |/injury, |/ASD, |/personality |/disorder, |/and |/PMDD |/in |/menstruating |/females Screening |/tools |/for |/pediatric |/bipolar |/disorder |/- |/CORRECT |/ANSWERS |/✔✔Mood |/Disorders |/Questionnaire, |/KRS |/Kiddie |/Schedule |/for |/Affective |/Disorders |/and |/Schizophrenia |/Mania |/Rating |/Scale, |/FIND |/criteria On |/K-MRS |/mood |/lability |/items, |/children |/with |/mania |/typically |/score |/- |/CORRECT |/ANSWERS |/✔✔• |/Moderate—many |/mood |/changes
|/throughout |/the |/day, |/can |/vary |/from |/elevated |/mood |/to |/anger |/to |/sadness |/within |/a |/few |/hours; |/changes |/in |/mood |/are |/clearly |/out |/of |/proportion |/to |/circumstances |/and |/cause |/impairment |/in |/functioning
- |/Severe—rapid |/mood |/swings |/nearly |/all |/of |/the |/time, |/with |/mood |/intensity |/greatly |/out |/of |/proportion |/to |/circumstances |/• |/Extreme— constant, |/explosive |/variability |/in |/mood, |/several |/mood |/changes |/occurring |/within |/minutes, |/difficult |/to |/identify |/a |/particular |/mood, |/changes |/in |/mood |/radically |/out |/of |/proportion |/to |/circumstances. Per |/the |/Diagnostic |/and |/Statistical |/Manual |/of |/Mental |/Disorders |/(DSM), |/one |/will |/experience |/at |/least |/four |/days |/of |/hypomania |/to |/be |/diagnosed |/with |/bipolar |/disorder |/- |/CORRECT |/ANSWERS |/✔✔yet |/over |/ 70 |/percent |/of |/children |/will |/instead |/experience |/various |/shifts |/in |/mood |/throughout |/a |/given |/day The |/Food |/and |/Drug |/Administration |/(FDA) |/has |/approved |/four |/medications |/for |/the |/treatment |/of |/pediatric |/bipolar |/disorder |/- |/CORRECT |/ANSWERS |/✔✔for |/those |/over |/three |/years |/old |/haloperidol |/is |/approved, |/for |/children |/over |/ 10 |/aripiprazole |/and |/risperidone |/have |/been |/approved, |/and |/for |/those |/over |/ 12 |/years |/old |/Lithium |/has |/been |/approved. Mood |/Stabilizers |/include |/- |/CORRECT |/ANSWERS |/✔✔Lithium, |/and |/anticonvulsants: |/Depakote, |/Tegretol, |/Trileptal, |/and |/Lamictal.
